Sarcopenia in Rheumatoid arthritis. A narrative review

Moschou, Dimitra; Krikelis, Michail; Georgakopoulos, Christos; Mole, Evangelia; Chronopoulos, Efstathios; Tournis, Symeon; Mavragani, Clio P.; Makris, Konstantinos C.; Dontas, Ismene; Gazi, Susana

doi:10.22540/jfsf-08-044

Cited by 13 publications

(10 citation statements)

References 55 publications

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“…As a result of the study, they stated that reducing or discontinuing glucocorticoids could prevent the development of sarcopenia [31]. However, glucocorticoid-induced skeletal muscle atrophy easily causes fatigue in daily physical activities such as climbing stairs and fast walking, and thus causes sarcopenia to occur with decreased physical activity [32]. Strategies to increase physical activity/ exercise in the sarcopenia treatment approach may provide positive clinical benefits in RA patients.…”

Section: Discussionmentioning

confidence: 99%

Examining the presence of sarcopenia in women with rheumatoid arthritis: Case-control study

Akar,

Calik,

Kabul

et al. 2023

Romanian Journal of Internal Medicine

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Introduction The aim of this study was to compare the frequency of sarcopenia, functional status, fear-avoidance behaviors, biopsychosocial status and quality of life in RA women with healthy controls. Methods 25 RA women and 25 healthy women were included in the study. Definition of sarcopenia was assessed using parameters recommended by the European Working Group on Sarcopenia (EWGSOP): Bioimpedance analysis for muscle mass (body fat ratio, skeletal muscle mass, skeletal muscle mass index); grip and knee extension strength for muscle strength and 4-m course gait speed test for physical performance was applied. Functional status was evaluated with the Health Assessment Questionnaire (HAQ), fear-avoidance behaviors with the Tampa Kinesiophobia Scale (TKS), biopsychosocial status with the Biopsychosocial Questionnaire (BETY-BQ), and quality of life with Short Form-36 (SF-36). Results While none of the healthy women had sarcopenia, severe sarcopenia was detected in 7 (28%) of the women with RA. When RA and healthy groups were compared; skeletal muscle mass (p: 0,004); skeletal muscle mass index (p: 0,011); grip strength-right (p:0.001) and left (p:0.001); knee extension strength-right (p:0.001) and left (p:0.001), 4-m course gait speed test (p:0.001), HAQ (p:0.001), TKS (p:0.001), BETY-BQ (p:0.001), SF-36 physical (p:0.001) ve mental component (p:0.001) results were significant in favor of the healthy group while there was no difference in body fat ratio (p>0.05). Conclusion In women with RA, the frequency of sarcopenia is higher, and functional status, fear-avoidance behaviors, biopsychosocial status and quality of life are worse than healthy.

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Section: Discussionmentioning

confidence: 99%

Examining the presence of sarcopenia in women with rheumatoid arthritis: Case-control study

Akar,

Calik,

Kabul

et al. 2023

Romanian Journal of Internal Medicine

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“…On the contrary, in our study, BMI was inversely associated with drug discontinuation. In elderly patients, maintenance of body weight is usually correlated with their health status, and a low BMI might be associated with sarcopenia ( 32 ). To reinforce this hypothesis, a very low BMI (< 20) is associated with a high discontinuation rate in elderly RA patients treated with CTLA4-Ig.…”

Section: Discussionmentioning

confidence: 99%

Retention rate of biologic and targeted synthetic anti-rheumatic drugs in elderly rheumatoid arthritis patients: data from GISEA registry

Manfredi,

Fornaro,

Bazzani

et al. 2024

Front. Med.

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ObjectivesAn increased number of elderly individuals affected by rheumatoid arthritis (RA) has been reported, including both patients with RA onset in advanced age and patients aged with the disease. In this registry-based study, we aimed to analyze the retention rate and cause of discontinuation of biologic (b) and targeted synthetic (ts)-disease-modifying anti-rheumatic drugs (DMARDs) in RA patients over 65 year old.MethodsRA patients enrolled in the Italian GISEA registry and starting a b- or a ts-DMARD over 65 years of age were included. Demographic, clinical, serologic, and therapeutic features were collected.ResultsA total of 1,221 elderly RA patients were analyzed (mean age 71.6 ± 5.2 years). RA was diagnosed before 65 years in 72.5% of cases, a 60.6% of patients experienced a previous b- or ts-DMARD. In patients older than 65 initiating a new b- or ts-DMARDS, tumor necrosis factor alpha inhibitors (TNFi) were prescribed in 29.6% of patients, abatacept in 24.8%, anti-interleukin 6 receptor antagonists (anti-IL6R) in 16.3%, Janus kinases inhibitors (JAKi) in 24.9%, and rituximab in 4.4%. The main causes of discontinuation were primary or secondary inadequate responses (66.1%). The median retention rate for all treatments was 181.3 weeks. A statistically higher retention rate was observed for abatacept when compared to TNFi (p = 0.02), JAKi (p < 0.001), and anti-IL6R (p < 0.001), and for TNFi vs. JAKi (p = 0.013).ConclusionWe described, in a real-life setting, elderly RA patients treated with a biologic or a ts-DMARD in Italy. Loss of efficacy was the main cause of discontinuation, and the DMARD safety profile suggests that age does not contraindicate their use. Our study reinforced that the control of disease activity is mandatory.

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“…Similarly, RA patients may experience sarcopenia (approximately 3-24%), which is associated with falls and poor functional ability [43]. Nutritional treatments are suggested for sarcopenia [44], indicating the role of diet in reducing functional ability including gait disturbances in patients with RA.…”

Section: Completeness and Applicability Of Evidencementioning

confidence: 99%

Combined Effects of Diet and Physical Activity on Inflammatory Joint Disease: A Systematic Review and Meta-Analysis

et al. 2023

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Research evidence suggests that, individually, diet and physical activity are effective interventions for reducing levels of inflammation in inflammatory joint diseases (IJD), however little is known about their combined use. This systematic review and meta-analysis aimed to examine the effects and/or associations of combined diet and physical activity interventions in IJD, specifically rheumatoid arthritis (RA) and the spondyloarthropathies (SpA) (PROSPERO registration number: CRD42022370993). Ten out of 11 eligible studies examined RA patients. We found that a combination of diet/nutrition and physical activity/exercise improved Health Assessment Questionnaire score (standardized mean difference = −1.36, confidence interval (CI) = (−2.43)−(−0.30), I2 = 90%, Z = 2.5, p = 0.01), while surprisingly they increased erythrocyte sedimentation rate (mean difference = 0.20, CI = 0.09–0.31, I2 = 0%, Z = 3.45, p < 0.01). No effects were found on C-reactive protein or weight (p > 0.05) of RA patients. We did not find studies in other IJDs that provided sufficient data for a meta-analysis. The narrative data synthesis provided limited evidence to address our research question. No firm conclusions can be made as to whether the combination of diet/nutrition and physical activity/exercise affects inflammatory load in IJDs. The results of this study can only be used as a means of highlighting the low-quality evidence in this field of investigation and the need for further and better-quality research.

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Sarcopenia in Rheumatoid arthritis. A narrative review

Cited by 13 publications

References 55 publications

Examining the presence of sarcopenia in women with rheumatoid arthritis: Case-control study

Examining the presence of sarcopenia in women with rheumatoid arthritis: Case-control study

Retention rate of biologic and targeted synthetic anti-rheumatic drugs in elderly rheumatoid arthritis patients: data from GISEA registry

Combined Effects of Diet and Physical Activity on Inflammatory Joint Disease: A Systematic Review and Meta-Analysis

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